Monetary Incentives Can Persuade Pregnant Women to Cut Back on Smoking

Pregnant women who are being treated for heroin dependence with methadone can be persuaded to reduce the number of cigarettes they smoke through monetary incentives, a new study suggests.

The researchers, from Johns Hopkins University’s Center for Addiction and Pregnancy, say an estimated 77 to 99 percent of pregnant women who are drug-dependent also smoke, UPI reports. Yet many substance abuse programs do not include a smoking cessation component, even though smoking can increase health risks to both the mother and fetus, they note. These risks include ectopic pregnancy, spontaneous abortion, low birth weight, preterm delivery and sudden infant death syndrome.

The researchers used contingency management to convince the women in the study to cut down on smoking. This method gives smokers monetary incentives for meeting specific goals. The study included 100 pregnant smokers who were prescribed methadone maintenance for dependence on heroin. One-third received increasing monetary incentives for cutting back on cigarettes or giving them up altogether. The women had to continually increase how much they cut back in order to receive money, until they were totally smoke free by the twelfth week. If they relapsed, they received no money, and had to start over.

Another third earned incentives for reducing smoking according to a schedule of payments not connected to their own smoking behavior, and the remaining third received information about the risks of smoking while pregnant, but did not receive any money.

Among the first group, nearly half of the women were able to cut back their smoking by 75 percent at least once, and a third of them gave up smoking altogether at least once by week 12. In the other two groups, none of the women were smoke free, and only 2 percent cut back by 75 percent during the 12-week study, the researchers reported in the journal Addiction.

The women in the contingency payment group had fewer preterm births and fewer babies with low birth weight compared with the women in the other two groups. They also smoked less in the weeks after birth, according to a journal news release.